Tennis Elbow: What is it?

Lateral epicondylitis is a condition where the outer part of the elbow becomes sore and tender. It is also known  colloquially as tennis elbow, shooter’s elbow, and archer’s elbow or simply lateral elbow pain.  While the common name “tennis elbow” suggests a strong link to racket sports, this condition is most commonly seen in two groups of people:

Manual Laborers

People who work with their hands are at greater risk of developing tennis elbow. Jobs that may lead to tennis elbow include plumbers, painters, gardeners, waiters, carpenters and even musicians like guitar players.

Sports Participants

Sports participants, especially racket sport players, are prone to developing tennis elbow. In addition to racket sports, tennis elbow is seen in golfers, fencers, swimmers and climbers to mention

Tennis Elbow Symptoms

• Pain over the outside of the elbow (lateral epicondyle)
• Pain when lifting objects and cocking back the wrist
• Pain from gripping and grasping objects and movements of the wrist
• Pain from activities that use the muscles that extend the wrist (back hand shot, pouring a container of liquid, lifting with the palm down as well as activities of daily living)
• Painful grip while shaking hands or turning a door knob
• Pain radiating down the forearm
• Weakness of the forearm
• Point tenderness over the lateral epicondyle
• Morning muscle stiffness

Causes

Tennis elbow is an overuse injury. The pain associated with this condition usually has a gradual onset.  Sometimes may also come on suddenly as a consequence of a trauma such as a direct blow to the epicondyle, a sudden forceful pull, or forceful extension. The acute pain that a person might feel occurs when they fully extend their arm.

In some cases the causes of the problem can stem from the shoulder and/or the neck. That means that the onset of tennis elbow can be the result of a combination of various factors like:

• Repetitive movements with either: – high intensity – poor technique – poor equipment – a combination of those
• Poor shoulder stability/control often resulting from poor posture at work and/or during activities. This also includes restrictions of movement resulting from old scar tissue and adhesions in other part of the body.

Irritation off the Radial nerve due to problems at the cervical spine (often posture related)

Prevention

Gradually increase the intensity of activity.

• Decrease the amount of playing time if already injured or feeling pain in outside part of the elbow.
• Stay in overall good physical shape.
• Strengthen postural muscles and improve shoulder stability.
• Strengthen the muscles of the forearm and the upper arm. Increased muscular strength increases stability of joints such as the elbow.
• With all sports and activities, use equipment appropriate to your ability, body size, and muscular strength.Make sure your working station is well assessed and take enough breaks during a repetitive task.
• Warm up before DIY and painting jobs https://swissphysio.co.uk/videos/pain-free-diy-part-1-warming-up-routine/ and cool down https://swissphysio.co.uk/videos/pain-free-diy-part-2-cooling-down-routine/  

Treatment

Treatments given at swissphysio always aim to solve the problems from the root. For this reason an experienced chartered physiotherapist or/and qualified TCM acupuncturist will first thoroughly assess you. They will focus not only on your elbow but also the whole body. This will include the bio-mechanics of neck, trunk, and arm in relation to your daily activities and your medical history.

Treatment usually includes

• mobilisation and manipulation of soft tissue and joints
• strengthening exercises for the arm, shoulder, neck, and core
• electrotherapy,
• kinesio taping, and stretching

We create an exercise program specific to the needs of the patient. If requested we can assess the workstation or the position of the car seat. When appropriate, we will suggest parallel treatment with a fully qualified acupuncturist to support the healing of chronic conditions.

In some cases, the severity of tennis elbow symptoms mend without any treatment within six weeks to twenty-four months. However, left untreated it can lead to chronic pain that degrades the quality of daily life. It is rarely an overnight cure.

It is rarely an overnight cure!

Medication

Typical non-steroidal anti-inflammatory drugs (NSAIDs) relieve lateral elbow pain in the short term, however they provide no improvements in functional outcome. Injected NSAIDs may be better than oral NSAIDs. There is insufficient evidence to recommend or discourage the use of oral NSAIDs.

 

Conditions treated